By: Panicha McGuire, M.A. ​

Most people think of depression as an adult mental health issue, but children and teens can develop depression too. Sometimes adults assume that children or teens can’t be depressed because they have nothing to worry about, but even those who live in a stress-free and loving environment can develop depression.

Many children and teens with depression are often left untreated because adults don’t recognize their symptoms. It can be difficult to tell whether a child or teen is going through a temporary “phase” or is actually suffering from depression. While most adults with depression look sad, children and teens may look more irritable or angry. Children and teens who cause trouble at school or at home could be suffering from depression.

Frequent talk or thoughts about death, dying, or suicide (in younger children, these themes may present themselves through play)

Hopelessness

Crying more often or more easily

Harming self (cutting, scratching, hitting)

It’s important to note that not all children or teens will have these symptoms. Some children and teens may continue to function well in their environment despite experiencing depression.

What can parents or caregivers do?The best thing parents or caregivers can do is to be proactive about your child’s mental health. Younger children often lack the language to tell their parents what they’re experiencing. Teens on the other hand may have a better understanding of depression but may feel embarrassed about coming forward. Learn the warning signs of depression in children and teens and take note of how long the problem has been going on as well as how often they happen. Then, you’ll have a record of concerning changes you can address with a mental health professional. Depression is treatable so seek help as soon as possible! ​If you are concerned about your child/teen and would like to talk with a Thrive Therapist about therapy, please reach out to us by phone at 858-342-1304.

As always, thanks for reading and comments are always welcome regarding any issues around child or teen psychotherapy services in San Diego by Thrive Therapy Studio.

To stay in the loop on the services offered at Thrive Therapy Studio and to receive updated information about Thrive, please feel free to sign up for the newsletter through the following link: http://eepurl.com/cvGx5n.

By: Dr. Erica Wollerman

As a therapist, the topic of failure comes up often in my work both with adults and with children/teens and their families. Over time, the topic of failure and redefining failure has become something that I am very passionate about. Part of this comes from my own personal history, as well as from my work with those grappling with their fears of failure or experiences they believe are failures.

Personally, I like to say that I am a “recovering perfectionist” because, well I work hard to defeat some of my perfectionistic tendencies, one of which is to fear and avoid failure. As a child, I often felt like a failure simply because I viewed myself in many ways as not good enough. This feeling was deeply connected, as perfectionism often is, to a deeper, underlying feeling of shame. Interestingly, the experiences that I have had through my life that have allowed me to grow and really work on my perfectionism, shame, and fear of failure have been horribly painful and difficult at the time. At times, I believe that I have most certainly failed during these experiences and while I would not necessarily “choose” them again, I can reflect on the growth and understanding they have brought to my life and believe they were worth it.

I find that these are also the experiences that allow me to relate so much with my clients. So many of my lovely, amazing clients have experienced the same feelings and fears of failure and these experiences have allowed me to grow into the therapist that I am, who can hopefully support and help them through these feelings and fears because I have truly been there. Walking with my clients through this experience is still one of the most profound experiences I have in my work.

So, that is a bit of the long, and personal, story of why I am passionate about redefining failure. I believe that if more of us believed that failure was an essential part of life, that it is productive and helpful, and not the worst thing in the world – we would as a whole be happier, more productive, and more resilient to deal with our failures. The truth is, we are all flawed as humans and we are going to fail and screw up and totally miss the mark sometimes. Isn’t it time that we accepted that and moved on rather than continued to punish and blame ourselves for our failures?

I love this quote by Michael Jordan where he talks about his failures and how they ultimately led to his successes. So often, it is the failure that leads us to success and there are so many famous stories that show this.

So, how can we as flawed humans view failure differently? I believe that we can think about and talk about failure differently for a start in the right direction. For example, we can look for the lesson and the opportunity to grow in every failure. I imagine that when Michael Jordan missed game winning shots, he spent very little time belaboring the pain of the miss and more time evaluating what could have been different and what he needed to learn to do better next time. If we start looking at every failure as an opportunity to learn something crucial for our success, it will likely feel differently and a lot less scary.

If you would like to talk with a Thrive Therapist about yourself, your child, or teen attending therapy with one of us, please reach out to us by phone at 858-342-1304.

If you would like to receive updated information about Thrive Therapy, please feel free to sign up for our newsletter through the following link: http://eepurl.com/cvGx5n.

By: Dr. Erica Wollerman

Making the decision to start therapy for your child or teen is usually a pretty difficult one for parents riddled with concerns about a variety of things… Does this mean something is “wrong” with my child? Will my child think something is wrong with them? Are they just going to complain about me? Will therapy even help them with the things I want it to help them with? And the list goes on, and on, and on!

As a child/teen therapist, I get these questions a lot and while I understand where the questions come from and the concerns parents have, I as a therapist am also, unsurprisingly, pretty pro-therapy. I believe that any and all of us can benefit from therapy and that going to therapy does not mean that anything is necessarily “wrong” with us or with our lives. Therapy can provide a safe space to explore ourselves, our lives, our reactions, and can provide us with a supportive person to walk with us through life’s challenges. I also think that children and teens respond particularly well to having an unbiased adult in their lives who can talk through situations and challenges in a way that parents, coaches, and teachers just can’t. So, I generally think that anytime is a good time to start therapy, but I thought a nice list of reasons to start might help parents make this decision!

Your child is experiencing symptoms that are starting to interfere with their life: This is very important – if your child is having symptoms of depression, anxiety, social skills issues, or behavioral issues that seem to be increasing and impacting your family more, that do not resolve within a week or so, an initial appointment with a therapist is definitely a good idea. Often, I find that parents struggle so much with the decision of bringing their child to therapy that they wait far longer than I would recommend. So, sooner is better than later in my eyes!

Your child or teen has experienced a significant loss or challenge. Therapy can be particularly helpful following a move, divorce, death of a significant person, or just a challenging time perhaps transitioning to a new school, grade, or family situation. Even if it is a short term experience just to make sure your child or teen is coping well, I would say all of these events are a great reason to bring your child or teen to therapy.

Your child or teen struggles to talk to you about challenges in their life. If you have a child who is either just not very verbal or who shuts down in response to difficult conversations with you, it’s a great idea to get them in therapy so that they can work on sharing and exploring their thoughts and feelings as well as learn how to have difficult conversations!

4.You believe your child does not fit in socially or is being bullied or bullying others. Kids who struggle socially or who are bullied or doing the bullying often will benefit from extra support. Considering that our social interactions are a huge part of our lives, it can be so tough for kids who feel that they do not fit in or who are being mistreated. Unfortunately, these issues place children and teens at greater risk of developing depression or anxiety in the future so it is important to support them before those issues develop.

5.Your child has a diagnosis or an IEP. If your child has a medical diagnosis or challenge going on, they will likely benefit from additional support. Additionally, if your child is diagnosed with a learning disorder, has an IEP for supports at school, or is diagnosed with a psychiatric disorder such as Autism, ADHD, Non-Verbal Learning Disorder, etc., providing them with the support of therapy can be so helpful. Children and teens who feel different for any reason greatly benefit from having outside supports where they can be themselves and work on developing coping skills to manage their challenges.

6.You have thought about how your child might benefit from therapy more than a couple of times. If you are spending a lot of time considering IF you should bring your child/teen to therapy, just go ahead and bring them in. Even if you are not sure why you are thinking it would be helpful, there is something that you are picking up on as a parent that I think you need to trust! Trust your gut and call for an intake… In my experience, sometimes parents do not know exactly what is “wrong” but get the sense that something is going on with their child/teen that they do not know about. In these situations, it is always better to be overly cautious than not provide support that could have been beneficial!

As I mentioned previously, as a therapist, I am definitely pro-therapy as you may have noticed through this blog! I will always recommend that it is better to call in and talk with a therapist about your family, child, or teen and see if they think therapy could be beneficial, rather than wait and let problems or challenges manifest into more problems or challenges. However, it is important to note that at my office, we are conservative in diagnosing children and teens (meaning we do not jump quickly to labeling and diagnosing unless those diagnoses are truly warranted) and that we will let you know if we feel your child or teen does not need services. So, just because you make the call as a parent, does not mean that you are signing your child or teen up for a lifetime of therapy!!

If you would like to talk with a Thrive Therapist about yourself, your child, or teen attending therapy with one of us, please reach out to us by phone at 858-342-1304.

If you would like to receive updated information about Thrive Therapy, please feel free to sign up for our newsletter through the following link: http://eepurl.com/cvGx5n.

By: Lindsey Brady, LMFT

As a Marriage and Family Therapist who specializes in children and teens, families often come to see me wanting help with specific behaviors that are happening in the home, at school, or in the community. Without the verbal understanding that adults have, children often resort to tantrums, crying, screaming, and yelling much to the frustration of most parents. It is important to remember that this behavior often serves a purpose for the child. It can communicate things that children are either unable to say or things they may not even be aware of on a conscious level. These are the five common needs that are communicated through behavior:

1. The need to connect - Listen, I get it! Life gets busy and responsibilities get in the way. Not to mention, dealing with negative behaviors doesn’t make it easy to slow down and connect, but this is a fundamental need that children have on a daily basis. Find at least 30 minutes each day to dedicate to your child. Family game nights, art activities, family outings, etc. all allow face-to-face time with each other to improve positive connections and positive relationships. Children are more willing to comply and behave in appropriate ways once they feel connected! And once they feel connected, they will be less likely to engage in negative behaviors.

2. The need for autonomy – This is a tough one for all parents. Children have a need to make their own decisions, which includes making their own mistakes. It’s hard to sit back and watch, knowing that your child may fail, but it’s vital that they be allowed to try. This develops courage, sense of self, and creates a supportive, loving relationship between parent and child.

3. The need to differentiate – Children are naturally curious and have a need to explore different opinions, beliefs, and values. Being free to be curious and create an identity without shame fosters loving, healthy relationships. This is a difficult need to balance, especially when teaching right and wrong is one of our duties as a parent. It is important to examine our own values and if there may be any motives behind wanting a child to be a certain way. This can allow parents to release expectations and allow children the space they need to grow into healthy, independent individuals.

4. The need for emotional comfort – Children have big emotions and equally big reactions. It is important to remember that young children are not able to regulate themselves and sometimes need extra support. Explain to children that ALL feelings are always okay and that they don’t need to hide them or suppress them. I like to teach children that feelings are like waves, if you don’t fight them - they pass. If you do fight them, they can pull you under. Extra hugs, love, and kindness help children to overcome and learn to self-soothe. If behavior is inappropriate, it’s okay to lovingly disengage until children calm down and then provide love and support and offer suggestions for how to handle feelings differently next time.

5. The need to feel respected and valued - When children are non-compliant and refusing to follow instructions, it is easy for parents to react with anger. The number one way that children learn from us is through modeling. If we model respectful and kind behavior, our children will respond and learn in the same manner. Remaining calm through challenges is not always easy, so don’t be afraid to take a break and address things later if you need to.

Next time your child is engaging in a behavior remember that they might be communicating a need and being aware of this is the first step towards helping your child to engage in more positive behaviors.

If you’d like to speak with someone regarding how to better understand and modify a child’s behavior, you can reach a Thrive Therapist at 858-342-1304.

If you would like to receive updated information about Thrive Therapy, please feel free to sign up for our newsletter through the following link: http://eepurl.com/cvGx5n.

The final part in our discussion of motivation by Erica

Thank you so much for continuing to read our blog series on Teens and Motivation! This is the final segment to our series and if you missed Part 1 and Part 2, check them out here and here!

We can’t discuss how to motivate teens without looking a bit more at what motivation actually is. In our culture, we often think of motivation as something that is a static, ongoing state. People are often described as being motivated, or not. Motivation is often thought of as something quick and easy that you can just become all of a sudden. Unfortunately, motivation is much more complex than all of this would suggest and despite what Oprah and her “aha” moments might tell you, it can be a long process in getting someone ready for change. Additionally, motivation is variable and changes over time.

When anyone presents for therapy, particularly parents on behalf of their children or teens, they are wanting changes and they usually want them quickly. A big part of my job is to understand the client and evaluate their readiness for change. A key component of how I do this is through utilizing a psychological theory called The Transtheoretical Model of Change by Prochaska and DiClemente which is often just referred to as Stages of Change for simplicity. This is a model of change that was initially used to understand addiction but is a helpful framework when considering any person who is contemplating a change in their lives.

Here is a brief overview of the stages:

Pre-contemplation: This can be summed up as the time before a person realizes that they either need or want to make a change. “I don’t need to change.” Sometimes referred to as “denial.”

Contemplation: When a person is considering change. The hallmark of this stage is ambivalence, which means that the person is on the fence about change. Perhaps part of them feels change is needed and possible but another part argues against it. “Hmmm… Should I change?”

Preparation: Getting ready to change

Action: Actually making the changes

Maintenance: Living the changes

Parents need to know the following about stages of change:

Stages of Change and motivation are directly connected

A person has motivation even when they are in the contemplation stage and not making changes

Motivation essentially means: our desire to change + confidence in doing so > fears, challenges of change, etc. This is usually a product of leaving the contemplation stage and entering preparation.

They are not linear – people go back and forth between these stages all the time

Example: Think of times you have tried to go on a diet or implement an exercise routine

At Thrive, we specifically focus on stages of change and helping our clients build motivation through a specific way of talking about change called “Motivational Interviewing.” This style of communication is collaborative and goal oriented and elicits and explores a person’s own reasons to change. We create a feeling of acceptance and compassion for our clients, rather than judgment or criticism. Our goal is to elicit “change talk” from our clients, which is when the teen talks about changes they want to make, rather than when I “tell” them what they should change.

This style of communication is what my ingredients for motivation try to mimic for parents. In review, we want to connect with our teens, have faith in their ability to problem solve, allow them to make mistakes, give consequences where appropriate, and let them lead! These are the ingredients that produce a collaborative environment and discussion similar to what we create in our office that can help you support your teen towards making changes and feeling motivated!

If you would like to talk with a Thrive Therapist about your child or teen attending therapy with one of us, please reach out to us either via email at ewollerman.psyd@gmail.com or phone at 858-342-1304.

For more information about the upcoming Parenting with Intention Workshop at Thrive, please contact Angela Bianco, ASW directly at 858-952-8835 or by email at angelabianco.asw@gmail.com. Angela is supervised by Erica Wollerman, PsyD (PSY25614) and questions regarding teen therapy can also be directed to Erica and the general Thrive team at 858-342-1304!

If you would like to receive updated information about Thrive Therapy, please feel free to sign up for our newsletter through the following link: http://eepurl.com/cvGx5n.

As always, thanks for reading and comments are always welcome regarding any issues around child, teen counseling and adult psychotherapy services in San Diego by Thrive Therapy Studio.

​By: Dr. Erica WollermanI recently went with a group of therapist friends to see the movie, Inside Out, which is, as many other child therapists have already noted, a child therapist’s dream movie. This is for a few reasons but primarily because it is based on the emotions or “voices” in our heads and the movie did a pretty wonderful job of demonstrating what each emotion is all about and what it looks like without the other emotions combined with it. Fear seemed to represent anxiety and sadness was certainly a great representation of depression. Anger was quite over the top anger that I often see with some of the kids I work with who have difficulties managing their big angry feelings.

The coolest thing about this movie is that it takes emotions and makes them an interesting and okay thing for kids to talk about, which can be unusual in our current culture that focuses a lot on happiness and avoidance of most other emotions. Some of the kids that have come into my office since seeing the movie have been more open to share about their feelings, using the movie as their platform for the conversation. As I stated before, this is a child therapist’s dream!

Another element of the movie that I really appreciated is that you get to watch an evolution of the characters, where they grow to understand that each emotion is important and that their person, Riley, will cope and live her best life if they are all working together, rather than just focusing only on Joy (which was how the movie began). I fundamentally believe that all of our emotions are important and useful tools in our lives and that issues arise when they get out of balance and we rely on one emotion and neglect the others. As such, this message was something I really appreciated.

Here are some questions and discussion starters that I have been using with kids in my office to help them open up about their feelings while also feeling like they are talking just about the movie:

What was your favorite part of the movie?

Which emotion do you think was most important?

How do you think things work when a person only feels one feeling at a time?

Was there anything about the movie that reminded you of the way you feel?

What emotion do you think is “in charge” of you a lot of the time (or it could be more than one)?

I can’t say enough how impressed I was with the movie and how easy it was to relate to it without having an over the top, educational or therapist vibe! I would highly recommend that any parent who is interested in talking to their child more about their emotions go see the movie with their child and then discuss it afterwards.

By: Dr. Erica WollermanAs many of you may know, I was recently interviewed by ABC News to comment on the trend that occurred in response to Zayn leaving the group, One Direction. Fans were cutting themselves and demonstrating their wounds publicly utilizing the hashtag, #Cut4Zayn on social media. Some posts even suggested to others to do the same because then Zayn would come back to the group. (If you did not catch the story and very small role I played, check it out here). Since so much of my interview was cut out from the story, I thought it would be nice to cover this topic in a blog post!

The more that I reflected on this particular scenario and the overall topic of self-harm, the more I felt strongly that instead of posting about more typical topics around cutting (how to stop people from doing it, what to do if your teen is cutting, etc) I wanted to have a discussion of WHY this might be happening so frequently and in such a dramatic, public way. Please keep in mind that this is mainly my opinion, which is based on what I see in my office and in our culture but not on specific, measured, scientific facts necessarily.

This topic also ties in with some of my fundamental beliefs about why people are feeling so stressed, anxious, unhappy, and disconnected because I think many people are cutting for exactly those reasons. While I might come off as entirely elderly during this post, I’m kind of okay with that! As I have gotten older, particularly given the work I do, I have gained such an appreciation for simpler times (which I would categorize my childhood in as I grew up prior to the internet in the 80s).

Here we go! The following is a summary about some factors I see as influencing Americans mental health and leading us to feel generally unhappy, disconnected, anxious, and stressed and which also could lead people into self-harming.

The Happiness Obsession: This is my way of saying that we are all SO focused on being happy all the time that I believe people are losing their ability to understand, accept, and tolerate discomfort and the less pleasant emotions. I covered this topic in another blog post as well (feel free to read that here) but in essence, I think that particularly younger individuals have an expectation of being happy and excited all the time. This is so entirely unrealistic that it is the definition of an unreachable goal but so many people may not realize this, which creates feelings of isolation and anger that THEY are not happy, since everyone else must be. After all, that’s what TV shows (well, happiness or complete and total DRAMA but that’s another topic). This also reduces our capacity to regulate ourselves through less pleasant emotions and situations, which can lead to cutting behavior.

General disconnection through mass media overload: I should preface this section by saying that I generally have a love-hate relationship with the media. While I love some great/terrible reality TV, I am also highly concerned about the impact TV, movies, the Internet, social media have on us as human beings. I believe that our expectations are so driven by what we see on the Internet that they are entirely skewed. I even find myself falling into this trap and thinking, well they have time for that (on my favorite show), why don’t I? While I mediate this thought by reminding myself that I live in reality and not a made-up world on TV, I can imagine how hard that is to do for someone who is younger, less mature, and likely to be less educated about how the media impacts our perceptions.

There is also the factor of how much time we spend connecting with other people in inauthentic ways, such as through social media or even texting. I find it concerning that so many of the teens I work with do not communicate with their friends verbally apart from occasionally at school. Most things are communicated through some sort of electronic source, which I believe reduces our ability to connect in an authentic way where we feel connected and heard by the other person. Plus, anything in writing could be misinterpreted, saved, and even used against someone and as such, many people are less likely to be truly vulnerable in writing. I believe that connection and vulnerability are so important in developing emotional resilience as well as shame resilience and without face-to-face communication, we are all lacking these skills to some extent.

Expectation of Perfection: Failure has somehow become such a dirty word in our culture. The sad thing to me is that so much of our learning comes from our failures and being open enough to try something different but we are all so consumed with being perfect and doing things “right” that we are often afraid to try something new. In many ways I do think our culture has forgotten that it is hard work, failure, and perseverance that drives success, not doing everything right all the time. I see parents often trying to help their children avoid any sense of failure, which unfortunately only leads to them never developing the resiliency to deal with failure and recover from it. This is particularly concerning to me because I do think this is a huge risk factor for self-injury as well. A shame spiral so quickly develops when we feel ashamed for our mistakes and can spin all the way down to being completely worthless, ashamed, and terrible which could certainly lead someone to feel like harming themselves in one way or another.

All of these factors lead to reduced emotional resiliency and regulation skills, which are key factors in developing healthy relationships and coping skills. My next blog will discuss ways to help facilitate resiliency in kids and teens. Stay tuned!

I hope you enjoyed reading this post! Let me know what you think in the comments section or feel free to send me an email.